,,ii  #aac? ,,congress  #b;d ,session   
,s4 #bhda  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,septemb] #ag          
7legislative day1 ,septemb] #af71       
#bjad,mr4 ,book] introduc$ ! foll[+     
bill2 :i* 0 read twice & ref]r$ to !    
,committee on ,heal?1 ,education1       
,labor1 & ,p5sions  ,a ,,bill  ,to      
provide = a /udy by ! ,in/itute (       
,m$ic9e on heal? disp>ities1 to direct !
 ,secret>y ( ,heal? & ,human ,s]vices to
 develop guidel9es on r$uc+ heal?       
disp>ities1 & = o!r purposes4  #a4 ,%ort
 title ,?is ,act may be cit$ z ! ,r$uc+ 
,disp>ities ,us+ ,c>e ,models &         
,education ,act ( #bjad4  #b4 ,f9d+s ,! 
,congress f9ds z foll[s3 7#a7 ,! infant 
dea? rate among ,african-,am]icans is m 
?an d\ble t ( ,:ites4  7#b7 ,! dea? rate
 = all canc]s is #cj p]c5t high] =      
,african-,am]icans ?an = ,:ites2 =      
pro/ate canc]1 x is m ?an d\ble t =     
,:ites4  7#c7 ,black wom5 h a high] dea?
 rate f brea/ canc] despite hav+ a      
mammography scre5+ rate t is ne>ly !    

same z ! rate = ,:ite wom54  7#d7       
,diabetes incid5ce is highe/ among      
,native ,am]icans1 at #ae4i p]c5t1      
foll[$ by #ac4b p]c5t =                 
,african-,am]icans1 #ab4h p]c5t =       
,hispanics1 #i4j p]c5t = ,asians1 & #g4f
 p]c5t = ,:ites4  7#e7 ,new cases (     
hepatitis & tub]culosis are high] 9     
,asians & ,pacific ,isl&]s liv+ 9 !     
,unit$ ,/ates ?an 9 ,:ites4  7#f7       
,individuals 9 same-sex c\ples 7 m      
likely ?an individuals 9 diff]5t-sex    
c\ples to report a delay 9 gett+        
necess>y prescriptions4  7#g7 ,infants  
born to ,black wom5 are #a4e to #c times
 m likely to die ?an ^? born to wom5 (  
o!r races or e?nicities1 & ,am]ican     
,indian & ,alaska ,native infants die f 
sudd5 infant dea? syndrome 7,,sids7 at  
ne>ly #b4e times ! rate ( ,:ite infants4
  7#h7 ,l[-income *ildr5 h high] rates (
 mortality 7ev5 ) ! same condition71 h  
high] rates ( disability1 & are m likely
 to h multiple conditions4  7#i7 ,:ite  
*ildr5 are half z likely z ,black &     

,lat9o *ildr5 n to be 9 excell5t or v   
good heal?4  7#aj7 ,z ( #bjab1 #ch4i    
p]c5t ( ,unit$ ,/ates adults 7 obese1 ) 
! highe/ rate among ,african-,am]icans  
at #dg4i p]c5t1 foll[$ by ,hispanics at 
#db4e p]c5t1 ,:ites at #cb4f p]c5t1 &   
,asians at #aj4h p]c5t4  7#aa7 ,! risk (
 /roke is twice z high =                
,african-,am]icans z = ,:ites1 &        
,african-,am]icans are m likely to die (
 /roke4 ,o!r e?nic m9orities also h     
high] risk ?an ,:ites4 ,ov]all1 /rokes  
are mo/ preval5t 9 ! ,s\!a/ ,unit$      
,/ates1 & less s 9 ! ,nor!a/4  7#ab7    
,african-,am]icans acc\nt$ = #dd p]c5t (
 all ^? infect$ ) ,,hiv1 despite be+    
only #ab p]c5t ( ! ,unit$ ,/ates        
population4  7#ac7 ,black m5 :o h sex ) 
m5 7,,msm7 ages #ac to #bd _h ! mo/ new 
infections among y\?4  7#ad7 ,"o /udy   
f\nd t among het]osexuals liv+ 9 ! same 
urban community1 ^? bel[ ! pov]ty l9e 7 
twice z likely to contract human        
immunodefici5cy virus 7,,hiv74  7#ae7   
,p]sons ) less ?an a high s*ool diploma 

7#f4g p]c5t7 & high s*ool graduates     
7#d4j p]c5t7 7 m likely to report major 
depression ?an ^? ) at lea/ "s college  
education 7#b4e p]c5t74  7#af7 ,only    
ab\t #aj p]c5t ( physicians practice 9  
rural ,am]ica despite ! fact t ne>ly    
"o-f\r? ( ! population lives 9 ^! areas4
  7#ag7 ,rural resid5ts are less likely 
to h employ]-provid$ heal? c>e cov]age  
or prescription drug cov]age1 & ! rural 
poor are less likely to be cov]$ by     
,m$icaid b5efits ?an _! urban c\nt]p>ts4
  7#ah7 ,tw5ty p]c5t ( nonmetropolitan  
c\nties lack m5tal heal? s]vices v]sus  
#e p]c5t ( metropolitan c\nties4  7#ai7 
,fifte5 p]c5t ( p]sons ) disabilities   
report n see+ a doctor due to co/ 9     
comp>ison to #f p]c5t ( ! g5]al         
population4  #c4 ,in/itute ( ,m$ic9e    
/udy  7a7 ,9 g5]al ,n lat] ?an #fj days 
aft] ! date ( ! enactm5t ( ?is ,act1 !  
,secret>y %all ent] into an arrangem5t )
 ! ,in/itute ( ,m$ic9e "u :i* !         
,in/itute agrees to /udy-- 7#a7 ! ext5t 
( heal? disp>ities 9 ! type & quality ( 

prev5tive int]v5tions1 heal? s]vices1 & 
outcomes 9 ! ,unit$ ,/ates2  7#b7 !     
factors t may contribute to inequities 9
 su* disp>ities2  7#c7 exi/+ programs & 
policies int5d$ to r$uce su* disp>ities2
  7#d7 be/ practices & successful       
/rategies 9 programs t aim to r$uce su* 
disp>ities2  7#e7 priorities =          
successful int]v5tion programs t>get+   
su* disp>ities2 &  7#f7 pot5tial        
opportunities = exp&+ or replicat+ su*  
programs4  7b7 ,report ,! arrangem5t "u 
subsection 7a7 %all provide = submission
 by ! ,in/itute ( ,m$ic9e to ! ,secret>y
 & ,congress1 n lat] ?an #bj mon?s aft] 
! date ( enactm5t ( ?is ,act1 ( a report
 on ! results ( ! /udy4  #d4 ,guidel9es 
= developm5t & implem5tation ( ,heal?   
,disp>ities ,r$uction ,programs &       
,activities  7a7 ,guidel9es ,n lat] ?an 
#ij days aft] ! submission ( ! report   
describ$ 9 section #c7;b71 & tak+ su*   
report into consid]ation1 ! ,secret>y   
%all develop guidel9es = entities to    
develop & implem5t programs & activities

 to r$uce heal? disp>ities4  7b7 ,use by
 ,,hhs ,! ,secret>y %all1 :]e           
appropriate1 incorporate ! use ( !      
guidel9es develop$ "u subsection 7a7    
into ! programs & activities ( !        
,dep>tm5t ( ,heal? & ,human ,s]vices4   
7c7 ,grants = disp>ities r$uction       
activities  7#a7 ,9 g5]al ,! ,secret>y  
may aw>d grants to entities = !         
developm5t & implem5tation ( programs & 
activities to r$uce heal? disp>ities 9  
accordance ) ! guidel9es describ$ 9     
subp>agraph 7a74  7#b7 ,applications ,to
 seek a grant "u ?is subsection1 an     
entity %all submit an application to !  
,secret>y at su* "t1 9 su* mann]1 &     
conta9+ su* in=mation z ! ,secret>y may 
require4  7#c7 ,m9imum cont5ts ,!       
,secret>y %all require t an application 
= a grant "u ?is subsection conta9s at a
 m9imum-- 7,a7 a description ( !        
population & public heal? conc]n !      
program w t>get & an outrea* plan to    
ensure t ! mo/ 9 ne$ populations w      
b5efit2  7,b7 a description ( !         

/rategies ! entity w use-- 7i7 to       
develop & implem5t its programs &       
activities 9 accordance ) ! guidel9es   
develop$ "u subsection 7a72 &  7ii7 to  
make ! int]v5tions su/a9able2 &  7,c7 an
 agreem5t by ! entities to p]iodically  
provide data ) respect to-- 7i7 !       
population s]v$2  7ii7 improvem5ts 9    
r$uc+ heal? disp>ities2 &  7iii7        
effectiv5ess ( ! int]v5tions us$4  7d7  
,appropriations ,to c>ry out ?is        
section1 !re are au?oriz$ to be         
appropriat$ #e1jjj1jjj = fiscal ye>     
#bjaf & su* sums z may be necess>y = ea*
 ( fiscal ye>s #bjag ?r\gh #bjbj4  #e4  
,te/+ alt]native paym5t & deliv]y models
 to r$uce heal? disp>ities  7a7 ,9 g5]al
 ,! ,secret>y act+ ?r\gh ! ,c5t]s =     
,m$ic>e & ,m$icaid ,innovation "u       
section #aaae;,a ( ! ,social ,security  
,act 7#db ,u4,s4,c4 #acae;a7 %all       
provide = ! te/+ ( a paym5t & s]vice    
deliv]y model t includes inc5tives =    
r$uc+ heal? disp>ities consi/5t ) ! co/ 
& quality crit]ia o!rwise applicable to 

! te/+ ( models "u su* section4  7b7    
,docum5tation requirem5t = model te/+ ,9
 c>ry+ out subsection 7a71 ! ,secret>y  
%all require t an application to conduct
 su* te/+ ( su* a model include at      
lea/-- 7#a7 docum5tation ( at lea/ "o   
heal? disp>ity t>get$ = r$uction2  7#b7 
a root-cause analysis ( ! heal? disp>ity
 t>get$ = r$uction2  7#c7 id5tification 
& selection ( p]=mance t>gets = su*     
r$uction2  7#d7 a proposal to make      
paym5ts 9 "s way cont+5t on a r$uction 9
 heal? disp>ities2 &  7#e7 a reliable   
me?od = monitor+ progress 9 a*iev+ su* a
 r$uction4  #f4 ,def9itions ,9 ?is ,act3
 7#a7 ,! t]m heal? disp>ity means       
significant disp>ity 9 ! ov]all rate (  
disease incid5ce1 preval5ce1 morbidity1 
mortality1 or survival rates 9 a        
population z comp>$ to ! heal? /atus ( !
 g5]al population4  7#b7 ,! t]m         
int]v5tion means an activity tak5 by an 
entity on behalf ( individuals or       
populations to r$uce heal? disp>ities4  
7#c7 ,! t]m ,secret>y means ! ,secret>y 

( ,heal? & ,human ,s]vices4